Don't Want to Increase Size, But Want to Gain Fullness During Breast Lift, Do I Need Implants as Well? (photo)

I am 33 years old and done having children. I am considering having a breast lift done but am concerned with how they will turn out after surgery. Ideally I would like them to be lifted and rounder. I am currently a size 32D-DD and dont feel like I want to add more sizewise, but I worry that if I do not add an implant that I will be left with flat looking breasts. I would like to not have the T shapped/lollipop scar, is that an option for me? Will I need an implant?

Doctor Answers 26

Auto Augmentation Mastopexy

If a woman has full breasts and wants to have perkier, more youthful looking breasts without adding volume, it is possible to lift the breast tissue and to reposition some breast tissue to create upper pole fullness without adding breast implants.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Breast Lift With or Without Implants

These are good questions that are very common in my practice. First of all you need a full lift. The periareolar or other short scar lifts are not going to allow your surgeon to improve your shape and increase the fullness of your breasts during surgery.

You appear from your pictures to have good breast tissue that will allow you to get a good result with your breast lift. It is possible to give you a full natural appearing breast without the use of implants. In your particular case the full lift you will improve the shape of your breast, the position of your nipple and have a round, full breast.

Especially since you don’t want to be any larger I would not use an implant.

I hope this helps, you look like a great candidate for a breast lift and will likely have a great result!

Johnny Franco, MD, FACS
Austin Plastic Surgeon
4.9 out of 5 stars 123 reviews

Breast Lift Without Implants

Thank you for the photos and questions, Sherrie. I agree with completely. You do not need and should not have a combined mastopexy (lift) and augmentation. You will gain some superior fullness and projection with a vertical lift (less with a Wise pattern). The reason you should not get implants at least initially is studies show that raising your nipple more than 4 cm and then placing an implant at the same sitting can lead to increased complications. I think you will be happy with a lift alone.

Jacob Freiman, MD, FACS
Miami Plastic Surgeon
4.4 out of 5 stars 272 reviews

Mastopexy without implants

Dear Sherrie,

you are right: using implants my not be necessary and  may open the door to a whole new set of issues.

nevertheless, a " lolipop scar " breast lift may be your best option with an internal reshaping of the breast tissue. that vertical T of the lolipop is essential in obtaining a nice conical breast, with a projected nipple. You do not need an " anchor scar " lift.

those scars are the trade - off to the lift, and will be included in all bras and bathing suits.

you still have to understand you will go down one cup size, since the breast tissue will be compressed and reshaped, and skin will be cut off. If you are a DD/ D cup, you will go down to a full C / small D.

Good luck,

Florence Mussat, MD


Florence Mussat, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 44 reviews

Breast fullness and firmness after lift usually requires an implant

Thank you for your question.  A breast lift alone will certainly improve the looks and natural feel of your breasts.

However in my experience a breast lift alone even with adequate breast tissue often produces a "jiggly" breast and does not feel firm.  This is best corrected with a breast implant.

However I agree with all the other surgeons that you should have the breast lift alone first.  You may be perfectly happy with the appearance and feel of your breasts.  If not to you can always have a breast augmentation at a later date after 6 months postop.

Upper pole fullness can be obtained without implants

A full breast size in the D to DD range with firm breast tissue can produce a beautiful breast shape with excellent upper pole fullness without implants.

We commonly use the breast tissue itself forming an "internal bra" (this procedure was also referred to as "laser bra" in the past) suspending the breast with multiple sutures and forming a full and supported shape.  With abundance of breast tissue to work with, implants are not necessary and a natural, round shape can be obtained predictably.

If a further increase in upper pole fullness is desired later, fat transfer can provide an excellent means of further increase and control over cleavage as well.  The scar pattern is dictated by the exact shape desired in the end.

Mario Diana, MD
Plano Plastic Surgeon
4.5 out of 5 stars 28 reviews

Upper Chest Fullness With a Breast Lift

Dear Sherrie, Thank you for your photos and question.To raise breast volume to the upper chest will significantly improve your shape.  You do not need an implant in my opinion.  Implants used for upper pole fullness often drop over time and do not gived the intended effect  You will however need removal of extra skin and rearrangement of your breast tissue.  Doing that requires incisions , which means that you will need to think that the improved shape is worth the tradeoff of scars. Good luck! 

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 116 reviews

LIft with or without implants

A lift will reshape your breasts but if you want a rounder shape, you'll most likely need implants. The implants will give you the rounder shape you want. In addition, a lift will decrease your breast size a bit, and the implants can help recover any lost volume.

Due to the amount of sagging you have, you'll most likely require a vertical scar.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 24 reviews

Breast Implants to Increase Volume Not Size

Many patients achieve a better shape to their breasts, such as increased superior fullness if an #implant is used at the time of #mastopexy. procedure can also be combined with a minor breast reduction to reduce the breast width if desired. #BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy.They will sag more and sooner because of the excess weight.The shape will usually not be satisfactory.

Another option to discuss with your Plastic Surgeon is #FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews


You definitely need a lift.  I would recommend that you not do implants unless you know you also want larger breast size or are willing to accept a substantially larger breast size.  For example, in order to get upper pole fullness with an implant, you will need implants wide enough to cover the base of your breasts, which will make you at least another cup size or two larger.  A lift is necessary in your case, and a mastopexy alone will give you a much improved breast shape and position, albeit with some scars.  This approach avoids a whole host of possible implant issues and is less likely to require revision procedures over time.  If you are unsure about the size you want, do a mastopexy first and you can always add an implant later. 

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.